Betty Joseph

Betty Joseph, who has died aged 96, was widely considered to be one of the
great psychoanalysts of her day.

5:54PM BST 23 Jun 2013

She devoted herself to analysing the process of psychoanalysis itself which, as an inquiry into the human mind, is inevitably considered to be a subjective – and so unreliable – science. Within the discipline, however, British practitioners are noted for their attempt to adopt an empirical rigour; Betty Joseph was the leading figure in this tradition, and admired all over the world for it.

Freud used the term “transference” to describe the complex things that happen when two people are together in the secure setting of the psychoanalytic treatment room. At the heart of Betty Joseph’s contribution was a profound set of thoughts about the phenomenon, beginning with her 1975 paper, The Patient Who Is Difficult to Reach.

In it she suggested that with some patients, interpretation of dreams or of what is said on the treatment couch were not the key to unlocking, identifying and ultimately dealing with past traumas – as was considered usual by psychoanalysts. Instead, Betty Joseph argued, it was not what some patients said, but the manner in which they said it, that was key. This “medium not the message” approach accounted for patients who, by creating constant questions about themselves but not attending to efforts to answer, say, forced those around them (doctors, perhaps, or family members) into a flurry of emotional activity while leaving the patients themselves becalmed and no closer to exposing the roots of their problems.

Such interactions between analyst and patient were, she observed, as if “one is talking about a patient – but never talking to the patient. The 'patient’ part of the patient seems to remain split off.”

To overcome this, she stressed that focusing on the past too early into treatment would only detract from the immediacy of the analyst-patient relationship and that interpretations should be rooted in the here-and-now, the moment-to-moment detail of every session.

This determination to address the reasons behind the behaviour of such “difficult patients” stemmed from Betty Joseph’s innate and fierce curiosity. But her work was nonetheless motivated by the desire to help those seeking treatment. In particular she was concerned with anxiety, inhibition, desire, perversion, mourning, guilt, envy and denial – sentiments sometimes acted upon by patients to destructive effect .

Betty Joseph’s novel way of thinking about transference came to permeate her discipline, as she taught her colleagues precise ways to focus on the minute instances of feeling and imaginative thought that occur when one person is trying to understand another. Teaching sessions at her consulting room in Clifton Hill – well supplied with trays of cakes and coffee – were attended by psychoanalysts from as far afield as Buenos Aires. Her influence was also expressed through her frequent attendance at international conferences, and has shaped psychoanalysis today as we know it.

Born in Edgbaston on March 7 1917, Betty Joseph came from a Anglo-Jewish family which had arrived in England in the early-18th century from Alsace. Her father had broken with the family jewellery tradition, instead studying Electrical Engineering before starting his own business.

The Depression years proved difficult, and Betty did not attend university. Instead she took a social science course and entered into psychiatric social work. Her two-month practical training took place in the East London child guidance clinic, then run by Emmanuel Miller, the father of Jonathan Miller.

Having won a scholarship to do a course in Mental Health at the wartime LSE, she first worked at Salford, near Manchester, helping to set up a new child guidance clinic. In the same period she began her first psychoanalysis with the noted Hungarian psychoanalyst Michael Balint. During the war she helped with Civil Defence and drove a lorry, also working with child evacuees. When Balint moved to London at the end of the conflict she followed him to complete her training, becoming a member of the British Psychoanalytical Society in 1949.

In 1962 she established a London seminar to examine ongoing cases from a clinical perspective. Running almost continuously for 49 years, the programme became the Betty Joseph Workshop, encouraging creative group discussion between analysts.

Her best work came late in life: Psychic Equilibrium and Psychic Change, a comprehensive collection of her essays, was published in 1989 when she was already aged 72. In it she described in detail how patients could draw the analyst into their attempts to protect themselves against the anxiety that accompanies any meaningful change.

Betty Joseph lived for five decades in St John’s Wood, where an inheritance from an uncle had enabled her to buy a house.